Nursing, what it's really like...

"Do you mind having him again?" Tracy asked. It was morning handover and my last day of a six day stretch. I didn't know how to look after Mr Jones, in fact none of us seemed to be doing to well when it came to dealing with Mr Jones. I shrugged my shoulders "Fine, no problem" I replied.

By 0715hrs the night staff had handed over their patients and the day was about to begin even though I didn't feel ready to face it quite yet. But that's not an unusual sensation around this place, especially this last week since a staff member had called in sick every day this week and we could only get a replacement nurse for three of those days. Today was one of those days that we couldn't get a replacement.

At the entrance to Mr Jones' room the smell of rot struck, my steps faltered briefly, but I continued on. Mr Jones was lying across the bed, his head pressed against the safety rail, the blankets on the floor and the dressings on his legs tangled somewhere amongst the blankets, leaving his stumps exposed.

Several years ago and multiple surgeries ago the surgeons had begun operating on his lower legs, but they refused to heal. A lifetime of neglecting his diabetes and heavy alcohol meant that the circulation to his legs worsened with each passing year and the ulcers became worse, became blackened dead areas.

Without fail the surgeons kept on cutting back his legs, starting at the toes and working their way up, until now he was just a torso with thighs... thighs that wouldn't heal.

Dealing with Mr Jones was a team event, but I had six other patients so with a guilty conscience I tore myself away from Mr Jones to do a very quick lap of the ward to see if any of my other patients were in a worse state. This ended up taking twenty minutes as my three female patients all needed assistance to get on the commode to relieve their bladders. On my way back to Mr Jones I grabbed my colleague and friend, Sarah, to help out. I promised myself to give Mr Jones the best wash, do all his dressings first, and take the time to sit and feed him myself to make up for leaving him in such a state.

"Get out of it" bellowed Mr Jones when Sarah and I straightened him up in his bed, "Get ya hands off me" Mr Jones was lay helpless between us "I'll call the Police, that's what I'll do." As I looked down at Mr Jones feelings of pity, sadness, and revulsion all mingled within my body. The revulsion came from the trail of slime his stumps had left on the bed as we had lifted him up.

Sarah was busy trying to calm him down while I prepared for the wash. One linen basket, one infections waste basket, one bowl of warm soapy water, fresh linen and blankets, multiple wipes, half a dozen towels (I sometimes get told off for using too many towels), stump dressings plus several other smaller dressing for the small bed sores he has on his elbows and sacrum.

It took half an hour to fully get Mr Jones cleaned, his bed changed, his dressings cleaned and drained. It didn't help that half way through the wash Mr Jones decided to move his bowels (hadn't moved for the last two days) without warning.

Once the hygiene cares were taken care of his blood sugar was checked and breakfast started. Of course his blood sugars were high and he had his usual morning insulin. His protests had eventually died down, but I knew it wouldn't last long, just hopefully long enough for me to take care of my other six patients.

Over the next hour I managed to get my other patients fed, watered and their medications done. I went back to Mr Jones, not in the least surprised to find him lying across the bed, his stumps exposed, his hands picking at his stumps. I had tried everything to try to keep him from being able to take his dressing off, I had even tried the soft boxing gloves which the ward sometimes uses for cases like Mr Jones, but no one had been able to get him to keep his stump dressings in place.

The shift eventually came to an end and I headed home for my two days off before the next six days of grueling care. I mean that's what care is, being willing to do the grueling, sometimes gross work while understaffed, underpaid and misunderstood.